Charge Number Charge Description Charge CPT Code 0042364527 Chest x-ray, single view $89.75 71010 0042364528 Chest x-ray, two views $110.85 71020 0049533561 CT scan, thorax w/o contrast $450.25 71250 0049533562 CT scan, thorax w/contrast $525.60 71260 0049533563 CT scan, thorax w/o and w/contrast $611.20 71270 0059781213 MRI chest, w/o contrast $985.00 71550 0059781214 MRI chest, w/contrast $1,062.65 71551 0059781215 MRI chest, w/o and w/contrast $1,145.70 71552